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NPI Code Detail

MEDICARE: MED 360 PLLC

MEDICARE: MED 360 PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1861132979
Entity Type Code : Organization
Provider Name (Legal Business Name) : MED 360 PLLC
Provider Business Mailing Address
First Line : 555 REPUBLIC DR STE 100
Second Line :
City : PLANO
State : TX
Zip : 75074-5400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 555 REPUBLIC DR STE 100
Second Line :
City : PLANO
State : TX
Zip : 75074-5400
Country : US
Telephone Number : 972-365-3514
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : DR. HASSAN FAROOQ
Credential : MD
Telephone Number : 972-365-3514
Provider Enumeration Date : 03/29/2022
Last Update Date : 03/29/2022

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Directions to “MED 360 PLLC ” Practice Location

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